Comment by cutety | Hacker News Reader

Comment by cutety | Hacker News Reader

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Thank-you. There is so much misconception in this thread its driving me crazy. I just went to the psych today to start pill roulette again and find a new therapist.

There is absolutely no reason for me to be unhappy and generally I'm not, I just don't feel anything except for some anxiety. I have an amazing job, an extremely supportive family, a nice apartment, several close friends. Yet, there are some mornings I struggle to get out of bed. There's no external source in my life currently (or past really) that is causing this. I have been diagnosed with ADHD, Depression, and Anxiety, several of my other family members (brothers, mother, grandmother, etc.) have some or all those things too. It's a very real, biological, sometimes genetic thing. It's a very complicated beast. There's no just recognizing it and overcoming it. Yes, I recognize a lot of my symptoms are caused by my brain, but that doesn't do a lot for me to be able to just overcome it when I can't even find the motivation to brush my teeth. It takes help, and a long time retraining your mind to not just immediately assume you're a worthless piece of shit not worthy of anything.

It's beatable, but when you're in the state of mind of a depressed person, you're not going to see that immediately.

/rant

Man I seriously sympathise with you. Allow me to extend my warmest congratulations and an invitation to join the 'shitty brain cooties trifecta' club. Unless you are someone who experiences greater confidence when taking amphetamines (not I), it's so bloody hard to treat these three conditions simultaneously!

Want to get out of bed in the morning? Sure thing, but good luck concentrating on anything when combining SSRIs with ADHD brain. Don't want to break out in a cold sweat at the prospect of being called on in a work meeting? No problemo, I hope you enjoy discovering the hidden depression sub-basement, and you thought you were already at the bottom of the pit.

Then there's all the crazy drug-drug interactions with CPY2D6 inhibiting anti-depressants and whatever else you might be on. I gets better if it's something like prozac or paroxetine, as both are simultaneously substrates and inhibitors of that enzyme (i.e. they inhibit their own metabolism so have non-linear DRCs... ah wacky fun).

But don't worry, you don't actually need drugs! All you need are positive thoughts filled with hopes and dreams, you filthy junkie.

/rant

On a more serious note, the only sustainable pharmacological treatments I can think of are:

- Dexamphetamine & beta-blockers (better chances if your anxiety is closer to a 'panic' disorder). This worked pretty well for me, until my local government health authority decided I couldn't be trusted with 'dangerous' drugs like dex. Far better to cast me back into the pit than to fuel our local ice epidemic, since clearly smoking meth is 'pretty much the same thing' as taking dex under medical supervision.

- Monotherapy with a non-reverse-able MAOI (e.g. Parnate, Nardil). Although good luck finding a psych willing to prescribe one, even if you can demonstrate you understand the interaction risks and know how to mitigate them.

Thank you as well.

I've had depression my entire adult life, and have been in a very similar circumstance to you.

I've been trying to 'think my way out of it' for many years, but it was never achievable. Finally a few months ago I bit the bullet and went to see a Clinical Psychologist, who quickly recommended me to a Psychiatrist and have started medication. I've always been extremely skeptical of anti-depressants given the nature of them and all the talk surrounding them. However, The effects of this medication have literally changed my life in the span of about 4-6 weeks. It was definitely the missing link in what I needed to do 'fix' my brain (chemically) to get everything onto the right path.

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